Mette Glavind Bülow

Lactate infusions have been widely employed for decades across experimental human physiology and clinical studies. Although often treated as a single entity, lactate exists as two enantiomers: L-lactate, the dominant physiological form derived from glycolysis, and D-lactate. In humans, D-lactate is generated in vivo through methylglyoxal detoxification and circulates at systemic concentrations that represent only a very small fraction of the L-lactate enantiomer [1].

References Berg-Hansen K, Gopalasingam N, Pedersen MGB, Nyvad JT, Rittig N, Søndergaard E, et al. Cardiovascular effects of lactate in healthy adults. Crit Care. 2025;29:30. Article PubMed PubMed Central Google Scholar Freire Jorge PJ, Boer R, Duška F, Nijsten MMW, Heldeweg MLA. Cardiovascular effects of hypertonic lactate solutions: acid–base or metabolic cause, or both? Crit Care. 2025;29:25–7. Article Google Scholar Mitchell JH, Wildenthal K, Johnson RL.

Eight healthy participants were enrolled in a randomized, controlled, single-blind, crossover study (Fig. 1). This study served as a pre-planned sub-study of a clinical trial aiming to assess the metabolic effects of LAC infusion, with detailed methods and results previously published [10]. Each participant received a four-hour infusion of LAC and SAL in random order on two separate study days, with a minimum interval of 14 days between the sessions.